Top PDF Pain, Depression and Quality of Life in Patients with Chronic Cervical Miyofascial Pain Syndrome

Aim: The aim of this study was to investigate the levels of depression, pain and disability in patients with chronic cervical miyofascial pain syndrome (MPS) and to determine their association with quality of life. Material and Method: Forty patients with Cervical MPS and 40 age and sex-matched healthy controls enrolled in this study. The social and demographic charac- teristics of the patients and controls were examined. All patients and con- trols were evaluated with respect to pain (at night, rest and movement) and assessed by visual analog scale (VAS). Neck disability index (NDI) was used to calculate functional disability. Quality of life was evaluated with the the Short Form 36 Health Survey (SF-36). Also all of the patients and controls underwent Beck depression inventory (BDI). Results: There was no statistical difference between the patients and control cases according to demographi- cal data. The SF-36 scores of the study patients were lower than controls. NDI, BDI and VAS scores were higher in the patients with chronic cervical MPS compared to controls. BDI scores of the patients with chronic cervi- cal MPS were negatively and closely associated with subparameters of the SF-36 (physical function (r:-0,599, p<0.001), role limitations due to physical functioning (r:-0,558, p<0.001), bodily pain (r:-0.540, p<0.001), general health (r:- 0,708 p<0.001), vitality (r:-0,692, p<0.001), social functioning (r:-0,559, p<0.001), role limitations due to emotional problems (r:-0,537, p<0.001) and mental health (r: -0,787, p<0.001). Discussion: BDI scores are higher in pa- tients with chronic cervical MPS than healthy controls and negatively affect their quality of life. Psychiatric evaluation of the patients with chronic cervi- cal MPS may improve their quality of life and treatments outcome.

Results: Total manual muscle testing score was 26.19 ± 13.24 (median: 29) in postpolio- syndrome group and 30.08 ± 8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported signifi- cantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional function- ing and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups.

Objective: to evaluate the incidence of chronic pain and its impact on the quality of life of patients submitted to inguinal hernioplasty using the Lichtenstein technique. Methods: this was a descriptive, cross-sectional study of patients operated under spinal anesthesia from February 2013 to February 2015 and who had already completed six postoperative months. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life. Results: out of 158 patients submitted to the procedure, we identified 7.6% as having inguinodynia. Of these, there was an impact on the quality of life in 25%. Conclusion: the incidence of inguinodynia after hernioplasty with repercussion in quality of life was similar to the one of found in the world literature.

A recent study conducted by Zannocchi et al (2008) showed that chronic pain in the elderly has a strong affective component and its intensity influences older patients' mood, nutrition, sleep and Quality of life (QOL). These authors stated the importance of pain assessment in the elderly, as a population at increased risk for under-recognition and under-treatment. Dewar (2006) also point out lack of research on assessing the impact of chronic pain on the psychosocial well-being of the older person living in the community.

A recent study conducted by Zannocchi et al (2008) showed that chronic pain in the elderly has a strong affective component and its intensity influences older patients' mood, nutrition, sleep and Quality of life (QOL). These authors stated the importance of pain assessment in the elderly, as a population at increased risk for under-recognition and under-treatment. Dewar (2006) also point out lack of research on assessing the impact of chronic pain on the psychosocial well-being of the older person living in the community.

Only mental component of the quality of life affected with psychiatric factor (depression) rather than the physical one. This is in agreement with the findings of Ding et al (13), and is further supported by our previous results, which indicated that subjective symptoms (pain and limb disability) were affected more than objective signs (range of motion) by depression and anxiety. The only domain in SF-36 questionnaire that was above the normal average was physical function. Wolf and Green studied the influence of comorbidities on quality of life in patients with frozen shoulder and found that physical function was inappropriately higher among PCS domains (8). They reported that except physical function, emotional role and mental health, other

We investigated the effectiveness of celecoxib in reducing symptoms in patients with difficult chronic pelvic pain syndrome (CPPS), NIH category IIIA. Sixty-four patients with category IIIA CPPS were randomized into two groups of 32 subjects each. One group was treated with celecoxib (200 mg daily) and the other with placebo. All patients underwent treatment for 6 weeks and were evaluated clinically before (baseline) and after 1, 2, 4, 6, and 8 weeks of treatment. The evaluation included the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and a subjective global assessment (SGA). Repeated measures analysis of variance was used to evaluate treatment and time effects and their interaction. A decrease (means ± SD) in total NIH-CPSI score from 23.91 ± 5.27 to 15.88 ± 2.51 in the celecoxib group and from 24.25 ± 5.09 to 19.50 ± 2.50 in the placebo group was observed during treatment (0 to 6 weeks). A statistically significant decrease was observed in pain subscore (P < 0.006), quality of life subscore (P < 0.032) and total NIH-CPSI score (P < 0.015) after 2, 4 and 6 weeks, but not in urinary subscore. In addition, 38% of the celecoxib and 13% of the placebo subjects had at least a moderate improvement in SGA. The trend was similar for the NIH-CPSI scores. However, the response to treatment in terms of total NIH-CPSI score or subscore was not significantly different from placebo after interruption of treatment for 2 weeks. Our results show that celecoxib provides sig- nificant symptomatic improvement limited to the duration of the therapy in patients with difficult category IIIA CPPS compared to placebo.

Additional data collected only from patients at the First Hospital affiliated to Sun Yat- Sen University. In addition to receiving the clinical evaluations and questionnaires described above, patients enrolled a tone of the 11 centers (the First Hospital affiliated to Sun Yat-Sen Uni- versity) were also asked to complete the following questionnaires: 1) patient health questionnaire (PHQ); and 2) pain catastrophizing scale (PCS)questionnaire. The PHQ is used as a screening instrument to diagnose common mental health disorders in a primary care setting; scores range from 0 to 27, and scores of 5, 10, 15 and 20 represent the (inclusive) cutoff points for minor, moderate, major and severe depression, respectively[16]. The PCS assesses three measures of negative thoughts associated with pain: rumination or worry (for instance, excessive attention to pain sensations), magnification(for example, reinforcing the threats of pain sensations), and helplessness (for instance, awareness of the inability to cope with the symptoms of pain); a total score of 38 points or more is taken to represent a clinically relevant level of catastrophizing[17].

The improvement in levels of pain, function- al capacity, and quality of life obtained from home exercise programs confirm the theory that cases of NSCLP with lower complexity can be treated and prevented in Basic Health Units. They do not require complex facilities or continuous supervision by a physical therapist, so other health professionals, with adequate training, can apply exercise therapy, lowering costs and preventing an overload of second- ary rehabilitation centers, which then would be able to focus in more severe cases, such as of patients with neurological deficit and post-operative. 7

RESULTS: Both groups had predominance of males, mean age of 47.3±16.5 years. With regard to labor, the group under he- modialysis (GI) had 80% of inactive patients. Most impaired quality of life domains were job situation and physical function. here has been prevalence of depression and anxiety, neuropath- ic pain and more pain complaint in GI, signiicantly interfering with general activities such as sleep and walking ability. here has been signiicant correlation (p<0.05) between anxiety, physical function and labor situation versus pain.

Background: Aquatic exercises have become a very important therapeutic option for chronic venous disease (CVD). here is evidence in the literature showing that this type of exercise is a mechanism that improves venous return and is important in vascular reeducation. hese exercises also help to reduce the venous hypertension caused by CVD, improving patients’ quality of life. Objectives: To analyze the efects of aquatic exercises on the quality of life of patients with CVD. Methods: his was a longitudinal, prospective, interventional pilot study conducted with 16 people with CVD classiied from C1 to C5. Participants were assessed at baseline using a data collection form and administration of two quality of life questionnaires, the SF-36 (Generic) and the AVVQ-Brazil (CVD-speciic), and an Analog Visual Pain Scale (AVPS). hey then undertook a program of 10 sessions of aquatic exercises, three times per week. he quality of life questionnaires and the AVPS were administered once more after all sessions had been conducted. Results: he data collected were subjected to statistical analysis to a signiicance level of p < 0.05. Patients exhibited improved quality of life as measured by the SF-36 in the domains Physical functioning, Physical role limitation and Pain (p < 0.05). he patients’ pain levels reduced after treatment according to the AVPS (p = 0.007). Only scores for the Pain and dysfunction domain of the AVVQ-Brazil questionnaire exhibited signiicant improvement (p = 0.013). Conclusions: Aquatic exercises were capable of improving aspects of quality of life and of reducing pain, demonstrating that they beneit patients with CVD.

The use of EQ-5D questionnaire gives us the opportu- nity to compare two ways of quality of life assessment; more self-independent assessment (EQ-5D part) with the assess- ment based completely on self-rating of one’s own health status (EQ-5D VAS part). Therefore, the highest value of this study is in revealing of independent factors associ- ated with both ways of students’ health-related quality of life assessment. The presence of chronic pain, depression and anxiety, need for urgent medical help, and visit to a clinical specialist in the past year are independently associ- ated with worse quality of life in both ways of assessment. In the multivariate analysis, we failed to demonstrate sex differences in both ways of assessing health-related qual- ity of life. Some previous studies have demonstrated sex differences in relation to the self-rated health status [3, 6, 15, 30]. Although health perceptions are likely to be sex- specific (since sex is associated with many other health outcomes [31], most previous studies have demonstrated these differences only in univariate analysis. Mikolajczyk and co-workers [3] performed both univariate and multi- variate analyses; sex differences were found only in the first one, but not in the second one. This is also consis- tent with the results of our study. These findings further support Mantzavinis and co-workers’ [32] recommenda- tions that analyses of self-reported health status should consider interactions among investigated variables.

BACKGROUND AND OBJECTIVES: In the last decade, the elderly population has grown worldwide, both in developed and developing countries. Together with the aging process, the preva- lence of chronic diseases and consequently the presence of pain are common and may have a strong impact on the quality of life of the elderly. The objective of this study was to evaluate the quality of life of elderly patients with and without chronic pain and to compare the quality of life with the number of chronic pathologies, pain intensity and age range.

Despite the positive and relevant results presented by this study, few hemodialysis services rely on professional physiotherapists in their CKD care team, so this study follows the new trends and warns about the underestimation of the introduction of this professional both in hemodialysis clinics and in nephrology services for patients who have diseases such as SAH and MD. However, other tools of greater accuracy and that allow more detailed functional evaluation could be used, such as spirometry, the power platform, the dynamometry and volumetry, in order to make possible the purchase of the efficacy of intradialytic physiotherapy with even more robust scientific data. In addition, other physiotherapeutic techniques could have their efficacy for the treatment of this group of patients proven, with the purpose of increasing the possibility and variety of procedures that professionals could use.

Sleep as one of the basic human needs plays an important role in physical and emotional refreshment. 12 Moreover, some disturbances during sleep cause cardiovascular diseases, 13 behavioral disturbances, depression 14 and anxiety. 15 Reduction of general health, pain and negative effects on quality of life are common in RA, 16 however fewer researches have been done on sleep disorders of patients with RA. Although new methods for RA have been presented with new medical technology, but there have not been significant outcomes in solving the psychosocial and sleep problems of these patients. According to studies, sleep problems are known to have negative impact on wellbeing and functioning, but the exact nature of the relationship between sleep disorders and RA disease is not completely understood. So even more research in this area is needed. 17,18 Also evidences indicate

RESULTS: he predominant age group was 40 to 60 years. 72% of the patients showed some bone changes and the major- ity interviewed did not have formal jobs at the time of interview. here was a noticeable increase in the intensity of pain in pa- tients with bone alterations when compared to those without, as well as an increased ambulation impairment. he Hospital Anxiety and Depression Scale showed a slight increase in both parameters in those with bone pain. Regarding the quality of life, physical function and work status were the most afected. here was the absence of alexithymia in most of the interviewees, a positive correlation between pain intensity versus physical func- tion (r=-0.14, p=0.03), physical function x work status (r=-0.28, p=0.04) and a negative correlation between alexithymia versus anxiety (r=0.03, p=0.62) and moderate pain versus overall health (r=0.06, p=0.40).

This research aimed to check the effective- ness of Therapeutic Touch on decreased pain intensity, depression self-assessment scores and improved sleep quality. A clini- cal before-after trial is presented. The study was carried out at a Basic Health Unit in Fernandópolis, SP-Brazil, involving 30 eld- erly patients with chronic non-oncologic pain who received 8 sessions of Therapeu- tic Touch in accordance with the Krieger- Kunz method. The Visual Analogue Scale for pain was applied before and after each ses- sion, and Beck Depression Inventory and the Pittsburgh Sleep Quality Index before the first and after the last session. Data analysis showed a significant decrease (p<0.05) in pain intensity, depression self- assessment scores and the sleep quality index. It is concluded that the Therapeutic Touch was effective to decrease pain inten- sity and depressive attitudes and symp- toms, as well as to improve sleep quality.

ated to what extent differences in the QoL between men and women could be explained by differences in the functional ca- pacity. The basis was the performance and chronic conditions, and they found that women (65.4%) had worse results than men in the QoL and functional capacity. Functional capacity and CD - arthritis, back pain, diabetes, and depression - were significantly associated with loss of QoL score. Therefore, the authors suggest that the negative report on the QoL in old women is due, mainly, to a higher prevalence of disability and chronic conditions. The present study found significant differ- ences in the quality of life regarding the number of diseases and intensity of pain, and women with the highest number of self-reported CD and higher pain intensity, according to VNS, had lower QoL score.

RESULTADOS: Dos 328 prontuários analisados, 180 (55%) apresentaram registro de dor pelo corpo (160 mulheres, 20 ho- mens), e 148 (45%) apresentavam dor apenas na região da face (116 mulheres, 32 homens). As áreas com maior relato de dor foram: cervical, lombar e ombros. O gênero feminino apresen- tou maior frequência de dores no corpo (com dor n=160, sem dor n=116, p<0,001) que o gênero masculino (com dor n=20 e sem dor n=32) com diferença estatística. Na maior parte dos casos a dor acometeu os dois lados do corpo (face 67% bilateral e corpo 92% bilateral)

Nociceptive pain results from the activation and sensitiza- tion of nociceptors. As a rule, it is associated with an actual damage, inflammatory process, trauma, or other cause that produces tissue damage or necrosis. Examples include pain due to bone metastasis and chronic inflammatory processes. Neuropathic pain is secondary to a partial lesion of the peri- pheral or central nervous system. It is frequently associated with allodynia and hyperalgesia. The most common syndro- mes include: peripheral neuropathies, medullary trauma after a stroke, and post-herpetic neuralgia. Mixed pain is present when those two mechanisms coexist, such as in lumboscia- talgia due to herniated lumbar disk.